The Hashtag That Resonates Reverberates

Over the past week, the #WorkMeHomeMe hashtag has been making some rounds on Twitter. 

It started with a couple tweets, an opinion, and then a call to action.

The Work-Me-Home-Me hashtag has awoken the self-deprecating side of MedTwitter. Unlike the oft carefully crafted and curated world of Facebook (as I remember it), Twitterites are juxtaposing their strong professional capabilities right alongside their…well… less stellar sides. Most – but not all – are MDs and women. Others want to play. 

And they should.

They should because the candid and public sharing of a seemingly contradictory combination behaviors demonstrates awareness that life can sometimes seem dichotomous. It helps us verbalize that we do not “keep our sh*t together” 100% of the time. More importantly, it demonstrates that we accept this as part of reality. Enough so, at least, that we can admit it to each other.

It can be validating just to read through these tweets. 

And apparently useful in educating one’s spouse of the Work-Me-Home-Me phenomenon:

The humor has the potential to lighten your mood:

And it can be sobering:

#WorkMeHomeMe tweets represent the honest reality of the work-life conversation, the work-life balance/juggle/symmetry/dichotomy/contradiction/harmony/whatever-else-we-may-call-it. Getting these raw glimpses into the lives of healthcare workers (and other professions) may be particularly valuable for so many who are starting their careers and already feeling stressed about how to be successful and perfect in all facets of life.

As empowering as #ILookLikeASurgeon – one of my favorite Twitter hashtags – is, #WorkMeHomeMe is the flipside, saying #IAlsoLookLikeThisAndItsOK.

And that can be empowering in a very different way.  

 

 

Kids get it.

Children never cease to amaze me.

During the holidays in our office, we had on our checkout desk a simple white Christmas tree the size of an 8oz paper coffee cup. It lit up and was a small part of our festive décor. As one of my patients checked out after an appointment, her daughter went right up to it, took in an audible and pleasantly surprised-sounding breath, and couldn’t help but exclaim, “Oh. It’s so beautiful!” A medical assistant and I just looked at each other and exchanged touched glances at the purity of the emotion.

Children are surprisingly forgiving, too. One minute they are upset about something a friend did, and the next, they can quickly find a way to look past it and be playful again. They are more resilient than we give them credit for. They want to be happy and they want others not to be sad.

Which is why I was both touched – yet not that surprised – at how some 1^st graders in Minnesota supported the Viking kicker who missed what should have been a winning field goal in the last few seconds of last week’s football game against the Seahawks. I was happy for my Seattle team, but couldn’t help but feel for Brian Walsh. Anyone who’s ever worked in any field (medicine or otherwise) that involves making and executing critical decisions in an instant understands that type of weight. And like medicine, though football is considered a team sport with many players, in the end, it can be one person who ends up shouldering (or feeling responsible) for a bad outcome. Even the understandably upset Vikings coach, who should lead his team as an example of sportsmanship, made an unsupportive, frustrated quip to the media after the game. Since then, he has provided a better perspective to his team’s loss of the game. And, of course, may people used social media as a platform for malicious commentary without consequence.

As someone who lived and breathed Bulls basketball in Chicago years ago, and now is exposed to some of the real tough challenges in peoples’ lives,  I can truly say that, in the end, “it’s only a game.” And we are – each one of us – human.

Those first-graders know that. Kids know how to bounce back. They know how to rally and support. We should all learn from them in this very real and important game of life.

Useful links on Measles and vaccination (supplementing Seattle Times column)

My column on measles and vaccination appeared in this past Sunday’s Seattle Times.

Here are some informative links to articles to help continue to inform/educate the reader on this important topic:

CDC information on measles

Benjamin Franklin’s story

Infographic

5 GIFs That Show Why Herd Immunity Is So Important

Measles Outbreak with a Baby at Home

You’ve Come a Long Way, Baby

Yesterday marked the 50^th anniversary of the landmark Surgeon General’s report on smoking and health. It really wasn’t that long ago that smoking was a way of life. As the author points out in this piece on why people smoke, even doctors had cigarettes in their mouth while examining patients back then. The Surgeon General himself, Dr. Luther Terry, was a smoker until a few months before he made his speech in 1964. And for something so deeply ingrained into the culture, so addictive, and a major part of the economy – the report was given on a Saturday in fear of a negative stock market response – we really have seen a remarkable decline in smoking.

The antismoking campaign is a major public health success with few parallels in the history of public health. It is being accomplished despite the addictive nature of tobacco and the powerful economic forces promoting its use.

–          CDC

We now have a better understanding how diffusely tobacco affects the body. People who smoke are at higher risk of everything we worry about getting: cancer, heart attack, stroke, vascular problems leading to leg amputation, and looking older. I see many adult children of smokers who have never smoked, deterred by their parents’ habit. But many children and young adults continue to experiment with smoking, often thinking that they can quit anytime. Unfortunately, smoking continues to be glorified in other settings. Hollywood practically gives them away, somewhat reminiscent of cigarettes being provided to US soldiers in the past.

We’ve come a long way, but we’ve got more work to do.

Winners, Losers at the Golden Globes

Beautiful dresses, talented actors.… What’s not to like about last night’s Golden Globes? Well, how about this little detail from the NYTimes that surprised me:

 6:27 P.M. |To Smoke or Not to Smoke at The Globes

Here’s the difference between Hollywood on screen and off: cigarettes. On screen they are taboo. If you see one it’s accompanied by some carefully scripted moralizing about the ills of smoking. And even then the folks at scenesmoking.org are wary. But here, they give the things away. Seriously. Out on the smoking balcony where we saw Sean Penn pacing and puffing a couple of years ago, tables are thoughtfully stocked with little glass holders crammed with dozens and dozens of recessed-filtered Parliaments. As for drinking don’t even ask.

— Michael Cieply

I cast no judgment on individuals who smoke. In fact, I cringe when others refer to smoking as “ugly” or “disgusting,” both very strong and judgmental adjectives. My job as a physician is to teach people about the harms of smoking and to help them try to quit when they are ready.

Though Hollywood often seems to live by different rules than “the rest of us,” I am fairly certain they are no more immune from the dangers of smoking. That is why I found this “thoughtful” provision of carcinogens at the Golden Globes to be a poor choice from a health and health economics perspective. People should be allowed to smoke if they wish, but maybe the Golden Globes should reconsider having cigarettes readily available next year.

No one but Big Tobacco wins when it comes to smoking.

————

*As an aside -because I can’t help but comment on the fashion- my three favorite dresses of the Golden Globes were worn by Berenice Bejo (Elie Saab), Rooney Mara (Nina Ricci), and Nicole Kidman (Versace).

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Dear TV Producers, You Forgot to Say “Don’t Try This at Home.”

Confession: I have been watching the reality show The Real Housewives of Beverly Hills. I don’t typically have time to watch television, but I end up attaching myself to one reality series for a season. Most often, it is a design competition or cooking show that I watch once a week, such as Project Runway or Top Chef.

Quite frankly, I don’t take shows like The Real Housewives seriously and often wonder if it is bordering on obscene to have such lavish lifestyles displayed on the televisions of homes across America (and around the world) during these hard economic times. But I was particularly disappointed in some of the footage that was shown on last night’s episode. On the show, one of the castmembers took an unknown amount of xanax (a prescription drug that can cause drowsiness and is used for particular types of anxiety) for a flight and was also filmed drinking alcohol (also an unknown amount, though it appeared to be more than 1 drink) while on it. She was clearly affected by the combination, exhibiting psychomotor slowing and slurred speech that was surprisingly more inappropriate than usual for this particular person. What’s worse is that her friends found her all the more entertaining while overly intoxicated and never once cautioned her (or the audience) against combining xanax and alcohol. As a matter of fact, I would argue, this combo seemed to be promoted by portraying this person as entertaining and funny and by devoting a fair amount of air time to her intoxicated state.

The risks of xanax-plus-alcohol were dangerously downplayed here. Both substances depress the central nervous system and can cause coma and death whe taken in excess quantities or used together. The combination of even small amounts can lead to dangerous levels of sedation, poor judgment, and unsafe situations.

I did a web search on the topic of xanax and alcohol and this particular episode to see if anyone else had commented on the high risk behavior depicted in the show. None of the search results explicitly pointed out the dangers of mixing the two drugs. In fact, most blogposts and articles painted it as “awesome entertainment.” The unfortunate fact is, though, that we now live in a time where more Americans die from prescription drugs than from car crashes.  So what makes for good television ratings makes a doctor like me cringe. Xanax is a high-risk medication. Irresponsible use of high-risk prescription drugs should not be glorified on television.

Dear producers, if you want to put that sort of behavior on TV – which I would rather you didn’t – then at least include a stern cautionary warning about it, even if it is only in writing at the end of the episode.

Hopefully, this particular castmember’s own doctor is watching the show and reminds her at her next appointment not to mix xanax and alcohol. Hopefully.

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“Absurd”

“Surely there is something absurd when a nation pays a primary care physician poorly relative to other specialists and then wrings its hands over a shortage of primary care physicians.”

– Princeton University economist Uwe Reinhardt

source: New York Times

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Vaccines and Public Health in the U.S.: We Need a (Celebrity) Hero.

“I was also fearful as a new mom but as a student of public health, I understand the evidence-based research now.”

– (author to be disclosed later in this post)

The above statement was made in reference to vaccines a little over a month ago… pre–Bachmann. Michele Bachmann, as the reader likely is aware, is the Republican presidential candidate who broadcasted second-hand, anecdotal, unresearched, fear-mongering on national television on September 12, 2011. She did this by relating the story of a woman who had told Bachmann that her daughter developed “mental retardation” after receiving the HPV vaccination. The American Academy of Pediatrics made a statement the very next morning refuting any link.  It was a wise and necesarry move which seemed swift, yet quite possibly neither fast nor impactful enough.

Bachmann’s words were disheartening to doctors and public health advocates who were just beginning to see some light at the end of the vaccine controversy tunnel – a path that had been leading to new outbreaks of measles, which had been rarely seen in the last few decades. The February 2010 retraction of a Lancet article written by Andrew Wakefield (which had linked vaccines to autism) gave doctors more confidence and something more tangible with which to bolster vaccination recommendations. This is not to say there wasn’t enough evidence prior to that. However, a mere 587 days after the retraction of Wakefield’s article, vaccine proponents were dealt another blow with Bachmann’s story.

One would suspect that the vast majority – if not all – of graduating medical students understand and would emphasize the importance of vaccination. But with primary care doctors squeezed from every angle imaginable in today’s healthcare environment, taking the time to discuss vaccines with each and every patient can seem nearly impossible. In a way, it would seem that doctors who do not have the discussion of the benefits and risks of vaccines have also somehow lost the vision that their role as physicians includes understanding and meeting the needs of the “greater good” of society, as well.**

So, in times of pro-vaccination despair, who will take up the torch?

We need a hero.

The most obvious answer would be a celebrity. Dr. Kevin Pho concurs, stating in a recent blog post,

“Doctors are playing from behind, both with their job of ‘unscaring’ people and combating the celebrity-laden anti-vaccine movement. We need to get more politicians and celebrities onto the side of evidence-based medicine in order to reframe the vaccine debate.”

There is a celebrity who has historically been against vaccination. There are those who promote clean water. As alluded to in a previous blog post, it seemed unlikely that any celebrity would educate the public about the importance of vaccination as fervently.  Salma Hayek, to her credit, has worked with UNICEF and a diaper brand to promote tetanus vaccination in Africa. While there are certainly a lot of commendable and valuable global efforts and not enough for the immense need, vaccination against preventable diseases should continue to be emphasized here in the US.

So, to return to the comment at the very beginning of this blog post, the author is a public figure whom I have been following on Twitter for a few months. She is a well-known advocate for global maternal health and an internationally–recognized supermodel. Last month, I was excited to see that she had posted a couple of valuable tweets regarding the benefits of vaccination, including links to a relatively tame Penn and Teller skit and to an article in the LA Times.

This individual is clearly using knowledge from her public health studies to help spread the word about the importance of vaccines.  I wouldn’t want to put her on the spot as a definite “spokesperson” for vaccination, but I do admire her recent use of Twitter to address this very important issue.

The fact remains, we need a public health hero. Christy Turlington is willing to contribute. Is anyone else?

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(**Choice and informed decision making are very important in Western medicine. But the “informed” part needs to be just that – truly informed. Physicians need to educate, listen, and address concerns. Educate more. Then decide together.)